Doctors, major problem in health care –PSN •You’re insincere – NMA

Pharmacists have accused medical doctors of posing threats to the lives of Nigerians through unethical practices. They challenged them to an open debate over their activities in the health sector.

The President, Pharmaceutical Society of Nigeria, Mr. Olumide Akintayo, who spoke to our correspondent on the telephone on Friday, accused doctors of breeding quacks through the training of auxiliary nurses and health attendants in private health institutions.

He said, “Medical doctors are about the biggest problem in health care. In Nigeria today, 99 per cent of them stock drugs in their private health facilities for prescription to patients. This is wrong; it is illegal. They constitute the biggest threat to lives in the health sector.

“Find out who trains auxiliary nurses and health attendants. When the trainees leave the setting, they spread to the communities to perpetrate illegalities.”

The PSN boss argued that pharmacists could not be held responsible for the purpose for which a drug is bought.

He blamed the unrestricted over-the-counter sale of prescription drugs on regulatory agencies. He called for the empowering of the Pharmacists Council of Nigeria to enforce and prosecute. He also urged the government to budget more funds for the sector.

Akintayo said, “As for drugs, the problem in Nigeria is that there is unhindered access to all categories of drugs. The regulatory agencies are not empowered financially too. Government earmarks about five per cent of its budget for health care, compared to 13 per cent of the minimum required.”

The Chairman, Nigeria Medical Association, Dr. Francis Faduyile, however, said pharmacists were insincere with their allegations.

According to him, training of nurses and health workers in private hospitals had been banned in Lagos State.

“Pharmacists consult within their shops and this is beyond their work. It is part of the rights of a doctor to prescribe and to leverage on a number of drugs. The major question is, ‘Are pharmacists ready to stop consulting in their shops?’

“If you go to any pharmacy to complain of headache or fever, drugs will be prescribed for you. Go there with the result of a blood test; you will see them giving you drugs. It is not about professional fight; let us do the right thing.”

I am surprise that a medical doctor can complain about consulting room in pharmacy it is a legal requirement for any pharmacy to have a consulting room because of privacy of patient and safety of patient, it has nothing to do with prescribing drug to patient, NIgeria doctor they lack a lot of basic knowledge about drug and the practice is still old they should stop their illegal activities they are doing regarding this safety, my problem about this is that Nigeria have limit number of pharmacist in the country, the number of pharmacist available in Nigeria are not enough to take on the work load, like Medicine use review, treatment of minor ailment, blood monitoring of certain drug like carbamazepine,clozapine, warfarin just to mention few, instead of Doctor to concern on advance treatment and also how to improve training for practice doctor because if you read some prescription, you can see that Doctor lack knowledge on drug and 99 per cent of them did not know the function of pharmacist, Pls private and public Medical doctor should visit National orthopaedic hospital Igbobi where everybody know their function and work in mutual benefit of the patient, the only thing national orthopaedic hospital need to work on is advance service which is essential for safety of patient, medical store need to be returned to pharmacy department.

MUSA OLAIWON

Nigerian Doctors are the problems of the system in Nigeria and i totally concur with the PSN about the observation and comments. In the United States of America and the United Kingdom, Nurses and Pharmacists can prescribe like doctors and it is not true that doctors only can prescribe medications to patient. I am a Nurse prescriber in United Kingdom and i was given additional training to do this. Nigerian doctors are very myopic and enemies of progress; they are still living in 1960 and having 1960 training and believe that they are alpha and Omega in healthcare system.
The Doctors in Nigeria need to grow up and open their eyes to modern healthcare system.
The doctors in Nigeria are shameless, arrogant and lack ethics of their profession.

I came to Nigeria to do voluntary work for a state hospital in my own town and what i saw there was shocking. Doctors were talking rudely to patients and sending patients to their own private hospitalsand coming late to work with reckless abandone.
No wonder, Government and powerful Nigerians has no confidence in Nigerians doctors and are sending important people to German, Saudi and USA for treatments. What a nation, what a profession.

Nigerian doctors are obstaccles to the Nigeria healthcare reform. The healthcare system is a shamble in Nigeria. Nigerian doctors has no moral right to be the head of Ministry of health because they have no management training to know about the complex health management that our healthcare service requires. In USA and UK, people who studied healthcare management are incharge of healthcare. These managers must go for further study in health management but the reverse is the case in Nigeria.
In addition to Nursing in which i am a senior person having practiced for thirty years both at home and abroad, i also studied law and currently studying Healthcare Law and Ethicsat a University in the United Kingdom. Nigerians doctors should be sued for manslaughter and murder taken into to consideration that some patient have died due to their negligence and uncaring altitude. Nigerian doctor put money above their calling.

Nigerian healthcare professionals need to work together and current servant and king relationship between healthcare professionals must come to an end. Nigerian nurses, pharmacists and other healthcare professionals that are allied to medicine are not inferior to doctors. Doctors studied what they likes and the samething goes for all other health professionals.
Nigerians doctors don’t demonstrate about poor equipments in the hospitals in Nigeria, they are only interested in their salary and don’t care about nurses meagre salary; what a shame. Nigerian doctors are very selfish and uncaring.
I agree totally with the PSN and i am very happy that somebody can speak out against these Mafia and cult like professionals.
Musa Olaiwon is a Nurse Practitioner working with the NHS in the United Kingdom.

baba

next time your wife has a obstructed labor or child has appendicitis,manage the situation yourself since you are a so-called experienced nurse or refer them to your pharmacist colleague

osikagbagbeola

@baba , and next time you need a tablet of aspirin,do the extraction, compunding and manufacture by yourself. O kay?

OBAFEMI

The problem here is system failure. Our health ministry caused this. check out its organisation compared with other countries in africa, uk usa, canada and australia this professional egoism will not surface.So dear pharmacist, nurses,lab scientist join forces with doctors to get a good health system where harmony and professional excellence rather than castigations of partners is a goal for all as we help how people.

adeyele

Dr Musa, sorry Mr Nurse Musa. You are just jealous. When next your wife needs a Ceasarian Section, ask your nurse colleague to cut her open. Give due respect to whom respect is due. Without doctors, you nurses and pharmacists have no orders to carry out in the first place. If something goes wrong with a patient, nobody blames you the nurse, or the pharmacist. It is the doctor’s fault then. If you are so passionate about prescribing, go to medical school and invest all the time, energy and money that doctors have invested.

dayo

Nigerian health sector is wack. i totally agree with you. I biomedical student from canada

kennotti

You indeed spoke your mind. You have the right to vent your anger and to express your misgivings. The fact you should find some space in your heart to accept is that nature and God orders somethings some ways for the safety of humanity. In medical affairs, the world is safest in the hands of doctors.

Olu

@Musa
Dear Musa, you made certain valid points, but your bitterness points to some ill feelings or discomforts you’ve borne for long, rather than a noble need for change.
1. In the hospital you visited, was it only the doctors shouting on patients? Weren’t the nurses too? Did you not notice that in those public centers, patient populations always overwhelm these workers(and pharmacists too)? Is it like that in the U.K?

2. Nigerian doctors divert patients and go on strike for money. Bad. Very bad!
Have you noticed the difference between salaries of doctors and politicians in the U.K, and the disparity between the pay of Nigerian doctors and politicians (and you, a nurse in the U.K)? Or have you not noticed that here in Nigeria, the man with the money(irrespective of where he got it) is the one respected, not the one with virtue? Should you rather not be angrier with our society as a whole? The history of foreign companies becoming corrupt in Nigeria, makes me suspect that given the same conditions, if you import doctors from the NHS, they probably wont fare better than their Nigerian counterparts in the long run.

3.Doctors don’t have management training. Not true. well, maybe it was true 20 years ago.
Today, you can’t head even a General Hospital without a management certificate course.

Dear Musa, maybe you think your qualifications could earn you a portfolio in Nigeria. I really wish it could. Maybe you’ve been away too long. You’d have realized that if you’re not “their friend”, those who appoint will choose someone with very little to offer way ahead of you, with all you have. This is corruption. This is our country. This is what we want to change, then everyone will have to fall in line.

afowowe chris

You may be right sir! Doctors i think after Government failure are the brains behind the backwardness of medical profession. Most of our doctors are half bake in knowledge because they think they are alpha and omega of our health sector which is totally wrong.

Sunday. Sylvanus

It is very unfortunate that the PSN chieftain sees the doctors
as the problems rather than the solution to the nation’s calamitous health system. It is this type of unguarded and derogatory remarks aimed at tarnishing the good image of the Nigrian doctors that has continued to constitute a cog in the wheel of progress of our health sector. Those of us that spend our good times envying medical doctors will soon find out that the medical doctors unique role in nature can never be wished way by enviousness . Medical doctors are God’s 2 ic.

John Doyle

Baba , I am not surprise because you are living in century country due to lack to knowledge with Nigeria doctor and Nigeria doctor are practice jungle medicine they are advance nurse few of them are really doctor, Musa I am sorry for Baba comment more grace to your elbow in nursing practice in uk.

DR. OBA

The medical profession has numerous specialties and anyone can decide to specialise in any of the subunits, likewise the pharmacy and nursing profession. It is high time medical professionals stopped castigating one another. Why should a nurse or pharmacist say Nigeria doctors are half-baked? Such shameful derogatory statements are pshychological signs of inferiority complex which should never exist in the first place because all medical specilaties are important. Be a good professional rather than engage in superiority contest and your patients will appreciate you better. It is doctors duty to prescribe ethical drugs and the pharmacists’s duty to dispense drugs, carry out pharmacovigilance e.t.c. No where in the world are pharmacists or nurses authorized to prescribe ethical drugs. They can prescribe over-the-counter drugs like multivitamins, pain relievers, malaria drugs. But ethical drugs for treatment of diseases like hypertension, diabetes, cancers, infertility, HIV e.t.c. are not to be prescribed by phamacists or nurses. So what is the bone of contention here? Everyone should be proud of his or her profession and desist from unnecessary supremacy tussle. The Medical and Dental Council of Nigeria does not support doctors training quacks and any known case should be reported to MDCN which will not take lightly such reports. Is a pharmacist or nurse trained to medically manage medical ailments or do they have the qualification to train doctors? So on what professional ground would a nurse or pharmacist say Nigeria doctors are half baked? Please let us respect one another and if you think another specialty is taking all the glory, then change your profession and commence medical training. It is as simple as that.

Uzo

There are many good physicians, pharmacists, nurses etc. There are very bad ones all over the place. The checks and balances are not enforced enough. So, chaos has taken over and our people are dying in their thousands from negligence and greed of physicians, pharmacists, nurses etc. The government needs to wake up.

ayodeji in Nigeria

Dr Oba, we are a victim of envy, nothing more nothing less. This is my 18th year of practice here in this country and I know the medical practice in Nigeria enough to be able to comment. I agree with you, and I know the labour, the sacrifice of doctors, what do we get in return? envy.

henry ajenu

The fundamental problem in the health sector in Naija is that ALL exisiting semi and full professionals,…Pharmacists, nurses, lab technologists etc ALL wanted to be Medical Doctors in the first place, and FAILED JAMB !!!. This professional jealouy is carried to the grave, unfortunately.

Evrey one is important, doctor, phramacist, nurse etc, but as in an airplane, there is only 1 CAPTAIN, even though the navigator, engineer, and common air hostess are all important. ALL semi and full professionals should just respect their professional roles and do away with this pathological jealousy, let us speak the truth, enough of this diplomatic bullshit !

http://voice-diary.blogspot.com Jide Olubiyi

Henry, you need good education. Pharmacists chose to be pharmacists, just like doctors chose to be doctors. I bet it’d disappoint you to discover the world doesn’t revolve around you. There’s much more to life than becoming an MD and spending one’s remaining productive life inside the hospital. No offense to doctors, it’s a big sacrifice to have to wake up and the only place you go is the hospital: we recognise that sacrifice… To say the least, it’s ridiculous to harbour the idea that pharmacists would like to be like doctors: one wonders what there is to gain in that. 😀

John Doyle

Dr Oba you did not need to show your lack of exposure to everybody from your statement that there is no where in the world that pharmacists and nurse prescribes ethical drug they can prescribe ethical drug if they have done independent prescriber course and also ddistrict nurse Practitioner can also prescribes ethical drug in UK and some areas in Canada Albert a Canada Toronto and many other area Australian check this or if you need a a proved i can sent it to you pharmacists also run special clinic like anticogulant clinic hypertension clinic asthma clinic pls Oba update your knowledge

Okwuchukwu

Olaiwon,

OBAFEMI

The problem here is our health system which was built on faulty health ministry. the organisation caused this professional egoism. In countries where things are done properly there is industrial harmony in health sector. PSN, MUSA Olaiwon and most of the people here failed as the problem is not the “doctor” as in general but in all profession there is bad egg.The pharmacist that sold out morphine or codiene causing psychoactive dependence in most states in northern nigeria or using marketers to sell out CLOZAPINE or Anti Retroviral drugs is he building or killing our health? So our health sector is poorly run because of policy foundation problem. it is better for nurses, pharmacist,lab scientists, judiciary and administrators to join doctors in fashioning good health system where harmony and professional excellence is the goal by this our country will be better for it and health tourism can be part of our pride as a proud nigerians. Stop this derogatory remarks as the politicians are feeding fat on this.

femi

until the physicians agreed that the health work is a team work and stop equating them self as the 2nd person after God we can’t get the best result in health sector. because the ve successfully segregated themselves from the team by their Celt centred acts

Chijioke Nwosu

Hmmm, very interesting indeed. First of all, doctors are not the problem of the nigerian healthcare system, systemic failure due to a myriad of reasons is. There’s no need for professinal rivalry because no two professions are exactly the same and every profession meets a particular need in society. For the guy who said all pharmacists, nurses, etc are people who wanted to be doctors but failed JAMB I would just say I’m sorry you think that way because it simply isn’t so. The reason everyone in the healthcare sector has a job in the first place is the patient, so let everyone, doctor, pharmacist, nurse, lab scientist or physiotherapist realise this and just be good professionals.

http://voice-diary.blogspot.com Jide Olubiyi

Chijioke, good thinking!

John Doyle

Obafemi thank for your excellent contribution, all this problem is Nigeria government as you said earlier is faulty health system, Obafemi agree with me that all this is the greediness of of the Nigeria leader lack of fund to run the agency that can regulate this, because before a clozapine can be dispense blood test need to be done to monitor agranulocytopenia which is monitor between manufacturer and pharmacist and this drug is licence treatment of refractory schizophrenia . I am disappointed about the practice you mention with pharmacist in Nigeria , because they are upto date with the rule and regulation all over the world and some of them event register with professional examination with a lot of question on ethntic but I will contribute a lot if I am back from my salvatican leave.

ken erons

John Doyle, are u sure you are who you claim you are? Reason i asked; your use of the English language is horrific. Poor tenses, disjointed sentences, poor punctuations and an insipid writing style……

http://voice-diary.blogspot.com Jide Olubiyi

@Ken erons, I feel you. It’s almost impossible to follow the sense John Doyle was trying to make. I guess we should take his post for a comic relief. 😀

Difu

ALL PHARMACY GRADUATES WITH MEDICAL DEGREE SHOULD FORM AN ASSOCIATION.They understand both sides very well.

Olu

Interesting debate I must say.Not a blog full of extreme words for one another. You’re all well done. Shows the caliber of people attracted to the topic.
If there are people who can remove this nation from its poor state, it’s the people here.Not politicians of the day. So don your gloves, time for talk is over. Its time to work!

Kolapo

Congratulations! PSN president. Nigeria health professionals need people like u, ride on, tell them the truth, only thruth can set them free.

truthseeker9ja

I concur with PSN,doctors should stop ‘manufacturing quack heathcare practitioner’.Just today in church I heard that a younglady is ‘learning’ nursing in one hospital in surulere and I recall seeing in okota lagos, a hospital located behind Access bank opposite mobil advertising vacancy for auxillary nurse!!!
The nigerian helthsector is accursed.The problem in the healthsector would get to the point where healthcare professionals would go physical.It happened in delta where a doctor commissioner of health slapped a nurse,it also happened in FMC Abeokuta,the same doctors made a complete mess NHIS and a noble initiative of having a working national health bill by surreptiously inserting a clause that may have allowed them to regulate other health professions(haba!!).It still beats my imagination what Olikoye Ransome-kuti was thinking when he carried out the coup that placed hospital administration in the hands of doctors.He should be held liable for the ruin the healthsector had become.no matter the amount of crash course management courses arranged for doctors to foist themselves as hospital administrators,it will not work.They will never be accepted because the health sector is peopled by knowledgeable practitioners and experts who can hold their ground.The solution lies in returning to the period when hospital administration is in the hands of neutral professionals who are graduates of administration have licenses to practice hospital adminstration .It is only a Nigerian doctor that would go on worldwide web and ignorantly assert that it is only a doctor that can prescribe. or insinuate that a doctor is superiior to a pharmacist who is the drug expert.This is the arrogance they have used to kill a lot of unsuspecting patients.Pharmacists are not those healthcare professionals who go on to do medicine.They are way way too sophisticated and comfortable.The doctors should des

truthseeker9ja

On illegal stocking of drugs,they are the conduits for fake and adulterated drugs.I recall a private clinic doctor who prescribed and dispensed an un-labelled drug costing 200% more than its actual cost for my mum and my mum struggled with identifying the name of the white tablet drug in an unlabelled container and I had to visit the clinic to enquire.Imagine,the doctor said he did so to prevent my mum from going to the pharmcy for re-stocking of her drug supplies!!I asked him if he knows the implication of what he has done,instead of showing remorse he was still fronting until I told him I am a pharmacist before he realised he is facing a potentially serious problem.This practise of prescribing and dispensing of un-labelled drugs sold by these private clinics at exorbitant prices is one of the greatest disservice being perpetrated by doctors in private practice because they are taking their patients for a ride,independent regulators or investigators like EFCC,not the toothless and compromised MDCN,should step in and save Nigerians from these make-money-at-all-cost doctors in private practice.
PSN should go ahead and create public awareness on patients right to know the drugs being dispensded to them at all times.They hold the public that responsibility.
On a globalscale,we all know that the biggest of all hospitals still cant stand the league of big pharmaceutical companies like GSK,PFIZER,ASTRA ZENECA,MERCK etc and in Nigeria,we have better managed private pharmaceutical companies like NIEMETH,EMZOR,M&B,FIDSON etc than the hospitals.Why is it so?it is very clear that the pharmaceutical sector is exposed to more regulation than the medical practise in Nigeria.There are more than 5 standard book of reference for drug production,the trainning leading to qualification as Pharmacist is very tedious and regulated on a global standard,you have the NAFDAC,PCN,SON,WHO-certification body and many more.It is clearly to ensure commom high standard is observed across board and if there is a deviation,the culprit can always be fished out.It happened in the mypikin saga,Pfizer Trovan case,alleged involvement of pharmacists in cynthia osukogu’s(of blessed memory) death.Fellow Nigerians,this is not the case with Nigerian medical practice,it is like a jungle,so much of lawlessnes.The MDCN is helpless as they have to contend with interferences from the hordes of influential doctors holding political offices.Why cant doctors in public service be sanctioned for operating private hospitals?Why cant they be sanctioned for diverting patients who throng public hospitals to their private medical business centre

AK

Doctors should perform their job of diagnosing & prescribing and then send the patients to the nearest pharmacy to obtain their drugs so that the pharmacist can perform their function of counselling the patient on the use of the drugs, side effects & drug-drug interaction which the doctor does not have the capacity & time to do & this function is essential for the complete & effective treatment of the patient

http://voice-diary.blogspot.com Jide Olubiyi

if you are a Doctor, wake up right now, because there’s no envying you. And in fact many other professionals busy with their own profession have no idea you even exist until you start another industrial action. (One wonders, are you known for anything else apart from industrial actions?). The words of PSN president only came as a reaction to recent NMA’s words saying pharmacists were the problems of the health sector. Go and look it up, pharmacists care no hoot about you lots until you get so restless and start to throw the brickbats. By the way, what warped sense of self-importance for some of you to ever think anyone wanted to be in your shoes! Wake up, this is the 21st century, how much do you collect as salary in a year, together with all the revenues from your private clinics that someone not in the health sector can not make in few months. And you really think being an MD is how to be wealthy! Boy, wake up and check out what it means to be in the pharmacy business. You ever wonder why more than 50% of pharmacists don’t take up jobs in the hospitals!
If doctors don’t like PSN’s words then they should rein in whoever is the illiterate that continues provoking bad blood on behalf of the NMA. It only suggests that NMA is feeling so threatened by pharmacists. Why would, for instance, pharmacists start publishing unfounded reports against Nurses, doctors, physiotherapists? They are not my business, their profession is different than mine. Every professional has its niche in the hospital, and it is really very dumb thing for NMA to start throwing unprovoked muds at pharmacists…what else does NMA expect after its provocative remarks…that pharmacists would come out and say, “O’ boy, well spoken!” NMA should be content with ensuring professional conduct from its members, as PSN and PCN for their own members. If NMA stops dragging all good-intentioned and rightfully busy doctors into needless fights with pharmacists, then there will be no ill-feelings with us.

pharm Busari A Azeez

The observation is ok Medical Doctors Stores more drugs and d practice is considered unethical and illegal but what happened to a Primary six older who open a Pharmacy Store,sells all categories of drugs and yet nobody challenges them. Some of them hav no address,some of them patent medicine stores i think the drugs are in d save hands when kept with d Doctors than d illitrates who considered drugs as a mere articles of trade .one wonders who is really in charge of drugs,d Doctors,Pharmacists, or traders on drugs ?Bold steps i think shd b taken to tackle d Problem of traders on drugs b4 facing dat of d Doctors

ganiu jimoh

@truthseeker,are u guys confused?if u really have the right to prescribe any drug u like to any patient,why wwas the pharmacist who prescribed the sedative arrested in Cythia’s case?I didn’t hear your beloved PSN talking about Clinical Pharmacy then!and the nurse from UK,are u sure dat u can really run a clinic where u prescribe and dispense drugs in the UK without a doctor?are u sure pharmacists to should take history,examine a patient,reach a diagnosis and start managing a patient in their pharmacy ‘shops’ without doctors,nurses and lab scientists over there in the UK?why do drug manufacturers state that drugs should be used according to Doctors prescriptions?here in Nigeria,we ecen have Pharmacists running Ate Natal clinics!is that what obtains in the UK mr Musa?even Doctors can’t say they can function without the nurses and lab scientist and hospital attendants,I’m yet to come accross a hospital in Nigeria,both private and public,that don’t have this departmentalisation.and you guys are now telling me that all that is needed to manage a patient is for a Pharmacist to rent a shop,carve out a ‘consulting’ room and start prescribing!you guys really need to go back to school!

OBAFEMI

@ ken erons and Jide this is not a time to question someone’s grammar but for serious discussions even anyone can use his/her native language so far that we can understand it but at the end it will improve our unhealthy health sector. @ truthseeker of what difference is auxillary nurse from patent medicine shop owner, medicine hawker?. 60-70% of our people lives in rural settings and they are worst hit.But come to think of this most of the so call “doctors” are male community health workers, male nurses, undergraduate medical students hired by hopital merchants that are non doctors but to make profit. But in ministry of health a dept that fight all this quackry is underfunded or not existing. So this fight is not about doctor or any other profession but faulty health sector. but someone must lead this battle and head our hospital so others mustnt envy this but support it because this disharmony in health sector is caused by politicians who feed on all of us and laugh us to scorn though they dont patronise us they go abroad where things are put in good other these politicians spent money on hospital infrastructures and boast of it but no formidable health policy and health structure, budgetary allocation is meagre so we all need to appreciate this fact and fight this monster the earlier we understand this the better for the pharmacist,nurses,lab scientist, health attendant,technicians,administrators and my medical colleagues.

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